LCO No. 5074 1 of 4 General Assembly Raised Bill No. 1332 January Session, 2025 LCO No. 5074 Referred to Committee on AGING Introduced by: (AGE) AN ACT CONCERNING NURSING HOME FINANCIAL ACCOUNTABILITY AND NURSING HOME OWNERSHIP BY PRIVATE EQUITY COMPANIES AND REAL ESTATE INVESTMENT TRUSTS. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. (NEW) (Effective from passage) (a) As used in this section: 1 (1) "Indirect ownership interest" means an ownership interest in (A) 2 an entity that has an ownership interest in a nursing home, or (B) an 3 indirect owner of a nursing home; 4 (2) "Nursing home" has the same meaning as provided in section 19a-5 490 of the general statutes; 6 (3) "Operational control" means to: (A) Influence or direct the actions 7 or policies of any part of a nursing home; or (B) choose, appoint or 8 terminate a member of the board, manager, managing member, senior 9 employee, consultant or other individual or entity that participates in 10 the operational oversight of a nursing home; 11 (4) "Ownership interest" means possession of equity in capital, stock, 12 Raised Bill No. 1332 LCO No. 5074 2 of 4 profits or ownership of real estate on which a nursing home operates; 13 (5) "Private equity company" means a publicly traded or nonpublicly 14 traded entity that collects capital investments from individuals or 15 entities; and 16 (6) "Real estate investment trust" has the same meaning as provided 17 in 26 USC 856. 18 (b) On and after October 1, 2025, a private equity company or real 19 estate investment trust shall not acquire or increase (1) any direct or 20 indirect ownership interest the private equity company or real estate 21 investment trust has in a nursing home, or (2) any operational or 22 financial control the private equity company or real estate investment 23 trust has over a nursing home. 24 Sec. 2. Subsection (a) of section 19a-491a of the general statutes is 25 repealed and the following is substituted in lieu thereof (Effective October 26 1, 2025): 27 (a) A person seeking a license to establish, conduct, operate or 28 maintain a nursing home shall provide the Department of Public Health 29 with the following information: 30 (1) (A) The name and business address of the owner and a statement 31 of whether the owner is an individual, partnership, corporation or other 32 legal entity; (B) the names of the officers, directors, trustees, or 33 managing and general partners of the owner, the names of persons 34 having a five per cent or greater ownership interest in the owner, and a 35 description of each such person's occupation with the owner; (C) if the 36 owner is a corporation which is incorporated in another state, a 37 certificate of good standing from the secretary of state of the state of 38 incorporation; and (D) if a private equity company or real estate 39 investment trust owns any portion of the business, any information 40 regarding such company or trust required to be disclosed (i) on federal 41 Form CMS-855a, and (ii) in accordance with 42 CFR 424.516 or 42 CFR 42 Raised Bill No. 1332 LCO No. 5074 3 of 4 455.104, as amended from time to time; 43 (2) A description of the relevant business experience of the owner and 44 of the administrator of the nursing home and evidence that the 45 administrator has a license issued pursuant to section 19a-514; 46 (3) Affidavits signed by the owner, any of the persons described in 47 subdivision (1) of this subsection, the administrator, assistant 48 administrator, the medical director, the director of nursing and assistant 49 director of nursing disclosing any matter in which such person has been 50 convicted of a felony, as defined in section 53a-25, or has pleaded nolo 51 contendere to a felony charge, or has been held liable or enjoined in a 52 civil action by final judgment, if the felony or civil action involved fraud, 53 embezzlement, fraudulent conversion or misappropriation of property; 54 or is subject to an injunction or restrictive or remedial order of a court of 55 record at the time of application, within the past five years has had any 56 state or federal license or permit suspended or revoked as a result of an 57 action brought by a governmental agency or department, arising out of 58 or relating to health care business activity, including, but not limited to, 59 actions affecting the operation of a nursing home, retirement home, 60 residential care home or any facility subject to sections 17b-520 to 17b-61 535, inclusive, or a similar statute in another state or country; 62 (4) (A) A statement as to whether or not the owner is, or is affiliated 63 with, a religious, charitable or other nonprofit organization; (B) the 64 extent of the affiliation, if any; (C) the extent to which the affiliate 65 organization will be responsible for the financial obligations of the 66 owner; and (D) the provision of the Internal Revenue Code of 1986, or 67 any subsequent corresponding internal revenue code of the United 68 States, as from time to time amended, if any, under which the owner or 69 affiliate is exempt from the payment of income tax; 70 (5) The location and a description of other health care facilities of the 71 owner, existing or proposed, and, if proposed, the estimated completion 72 date or dates and whether or not construction has begun; 73 Raised Bill No. 1332 LCO No. 5074 4 of 4 (6) Audited and certified financial statements of the owner, including 74 (A) a balance sheet as of the end of the most recent fiscal year, [and] (B) 75 income statements for the most recent fiscal year of the owner or such 76 shorter period of time as the owner shall have been in existence, and (C) 77 evidence demonstrating compliance with the provisions of section 1 of 78 this act; and 79 (7) If the operation of the nursing home has not yet commenced, a 80 statement of the anticipated source and application of the funds used or 81 to be used in the purchase or construction of the home, including: 82 (A) An estimate of such costs as financing expense, legal expense, 83 land costs, marketing costs and other similar costs which the owner 84 expects to incur or become obligated for prior to the commencement of 85 operations; and 86 (B) A description of any mortgage loan or any other financing 87 intended to be used for the financing of the nursing home, including the 88 anticipated terms and costs of such financing. 89 This act shall take effect as follows and shall amend the following sections: Section 1 from passage New section Sec. 2 October 1, 2025 19a-491a(a) Statement of Purpose: To prohibit private equity companies and real estate investment trusts from acquiring or increasing (1) any direct or indirect ownership interest in a nursing home, and (2) any operational or financial control in a nursing home. [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]